Revised Autism Screening Tool Offers More Precise Assessment

Posted on Friday, January 10, 2014

Revised Autism Screening Tool Offers More Precise Assessment          According to researchers supported by the National Institutes of Health, an updated screening tool that physicians administer to parents to help determine if a very young child has autism has been shown to be much more accurate than earlier versions at identifying kids who could benefit from further evaluation.
The Modified Checklist for Autism in Toddlers — Revised, with Follow-Up (M-CHAT–R/F) — is a free, two-step screening tool used to detect children likely to have autism. It is intended for use at regular well-child checkups for children 16 to 30 months old. With the M-CHAT-R/F, health care providers can classify a child’s risk of having autism as low, medium or high, on the basis of parents’ answers to 20 questions.
The study, funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), shows that this revised checklist can more accurately identify children likely to have autism so they can get the treatment and support they need. “Given that the typical autism diagnosis occurs at age 4, it also offers the possibility of detecting autism much earlier — during regular doctor’s visits when a child is 18 months or 2 years old,” said Alice Kau, Ph.D., of NICHD. “And earlier intervention has been shown to improve outcomes for children with autism.”

A score in the high-risk range warrants a referral for further evaluation for possible autism. For a child determined to be at medium risk, M-CHAT-R/F includes a follow-up questionnaire used soon after the original evaluation to obtain additional information needed to more definitively classify the child as either high risk or low risk.

Based on the M-CHAT-R/F classifications, the researchers found that a smaller proportion of children received a medium- or high-risk assessment (7 percent) than with earlier versions of the checklist (9 percent). However, more total cases of autism were detected with the revised checklist than with earlier versions (67 cases per 10,000 screened vs 45 cases per 10,000 screened).

Of the more than 16,000 children evaluated with the screening tool, 93 percent of the children screened were considered low-risk, 6 percent were in the medium-risk range and 1 percent were considered high-risk.

Of all the children determined by the test to be at risk after the M-CHAT-R/F follow-up, 95 percent were eventually found to have some form of developmental delay, including more than 47 percent with autism spectrum disorder.

According to Deborah Fein, Ph.D., senior author of the study, “Earlier tools cast a wider net, but these refinements will allow healthcare providers to focus energy where it is needed most and will reduce the number of families who go through additional testing but which ultimately do not need treatment interventions."

The findings of this study appeared in Pediatrics, the journal of the American Academy of Pediatrics.

The M-CHAT-R/F is available online, in more than 45 languages. To download this free autism screening tool, please click here.
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